miR-451a was selectively sorted into exosomes and promoted the progression of esophageal squamous cell carcinoma through CAB39.

Exosomes are emerging mediators of cell-cell communication, which are secreted from cells and may be delivered into recipient cells in cell biological processes. Here, we examined microRNA (miRNA) expression in esophageal squamous cell carcinoma (ESCC) cells. We performed miRNA sequencing in exosomes and cells of KYSE150 and KYSE450 cell lines. Among these differentially expressed miRNAs, 20 of the miRNAs were detected in cells and exosomes. A heat map indicated that the level of miR-451a was higher in exosomes than in ESCC cells. Furthermore, miRNA pull-down assays and combined exosomes proteomic data showed that miR-451a interacts with YWHAE. Over-expression of YWHAE leads to miR-451a accumulation in the exosomes instead of the donor cells. We found that miR-451a was sorted into exosomes. However, the biological function of miR-451a remains unclear in ESCC. Here, Dual-luciferase reporter assay was conducted and it was proved that CAB39 is a target gene of miR-451a. Moreover, CAB39 is related to TGF-ß1 from RNA-sequencing data of 155 paired of ESCC tissues and the matched tissues. Western Blot and qPCR revealed that CAB39 and TGF-ß1 were positively correlated in ESCC. Over-expression of CAB39 were cocultured with PBMCs from the blood from healthy donors. Flow cytometry assays showed that apoptotic cells were significantly reduced after CAB39 over-expression and significantly increased after treated with TGF-ß1 inhibitors. Thus, our data indicate that CAB39 weakens antitumor immunity through TGF-ß1 in ESCC. In summary, YWHAE selectively sorted miR-451a into exosomes and it can weaken antitumor immunity promotes tumor progression through CAB39.

Transmission of depressive symptoms in the nuclear family: a cross-sectional and cross-lagged network perspective.

Children are more likely to develop depressive symptoms in families where parents have depressive symptoms. By conceptualizing the individual depressive symptom network of each family member as a whole, this study proposes a family symptom network model, and explored the mechanisms of transmission of depression within nuclear families at the symptom level. This study used four waves (2012, 2016, 2018, 2020) of data from the China Family Panel Studies (CFPS), which in wave one contained a representative sample of 1963 children (1038 boys; age = 12.60), 4763 mothers and 4614 fathers from China. Children with their parents completed the Center for Epidemiology Studies Depression Scale at each wave. Individual depressive symptom networks among children, fathers, and mothers were highly similar and stable across time. When considering depressive symptoms of all family members as a whole, there was a wide range of associations between child, father, and mother depressive symptom networks. The results of the cross-lagged network model suggest the bidirectional relationships between couples and parent-child depression. The current study provides preliminary validation of the family symptom network model. The model represents a further integration and extension of network theory of mental disorders and family systems theory, and points out the limitations of studying the intergenerational transmission of depression from a latent variable perspective. Thus, the family symptom network model proposed in this study could provide valuable new insights into understanding the intergenerational transmission of depression.

Pandemic fatigue and depressive symptoms among college students in the COVID-19 context: indirect effects through sense of control and intolerance of uncertainty.

Pandemic fatigue, the state of weariness, exhaustion, and demotivation to engage in protective behaviors during the coronavirus disease 2019 (COVID-19) pandemic, have been linked with depressive symptoms. However, the mechanism underlying this association remains unclear. Based on the stress process model, the present study examined the indirect effects of pandemic fatigue on depressive symptoms through the indirect roles of sense of control and intolerance of uncertainty. Data were collected from 1,162 Chinese undergraduate and postgraduate students (Mage = 21.61 years old, SD = 2.81, 64.29% women) through electronic questionnaires. The pandemic fatigue scale, the personal mastery scale, the short version of the Intolerance of Uncertainty Scale, and the Depression subscale of the Depression-Anxiety-Stress Scales were employed. Indirect effects were analyzed using structural equation modeling. The results revealed that pandemic fatigue related to COVID-19 was positively associated with depressive symptoms through (a) sense of control; (b) intolerance of uncertainty; and (c) a sequential pathway from sense of control to intolerance of uncertainty. The findings expand the application of the stress process model to the context of COVID-19 and deepen the understanding of pandemic fatigue-depressive symptoms link with considering the indirect roles of sense of control and intolerance of uncertainty. Psychological distress in the context of COVID-19 could be alleviated by the interventions on strengthening sense of control and tolerance of uncertainty and lessening the adverse effects of pandemic fatigue.

Enacted Stigma Influences Bereavement Coping Among Children Orphaned by Parental AIDS: A Longitudinal Study with Network Analysis.

Purpose: The study aims to understand how enacted stigma influences bereavement coping at the style (scale) level and the specific pathways at the strategy (item) level. Methods: The longitudinal data of 755 children orphaned by parental Acquired Immune Deficiency Syndrome (AIDS) in rural China were used. Grief processing and deliberate grief avoidance were measured at wave 1 (baseline) and wave 2 (one-year follow-up) to reflect bereavement coping in the contexts of being with family members, being with friends, being with community members, and being alone. Enacted stigma that measured at wave 1 was used to assess the experienced stigma of these AIDS-orphaned children. Network analyses were run following regressions. Results: Controlling for demographics and baseline-level bereavement coping, multivariate regressions revealed that enacted stigma at wave 1 significantly predicted grief processing and deliberate grief avoidance at wave 2. Network analyses showed that, for grief processing, stigma increased searching for meaning alone and with friends and expressing feelings to community members, which then provoked the same strategy across contexts. Meanwhile, stigma triggered the deliberate grief avoidance network by initially suppressing the expression of feelings to community members. Conclusion: Enacted stigma contributes to bereavement coping. Stigma stirs up complex feelings but forces AIDS-orphaned children to suppress expressions, and it increases needs to process grief through meaning making but cuts supporting forces by promoting avoidance. Interventions are imperative to reduce stigma, improve emotion regulation, and facilitate meaning making for people bereaved by stigmatized deaths.

Relationship between psychological detachment from work and depressive symptoms: indirect role of emotional exhaustion and moderating role of self-compassion.

The importance of psychological detachment during nonwork time has been emphasized, and its effect on depressive symptoms has been identified. However, the mechanism underlying this association remains to be elucidated. This study was conducted to identify the indirect role of emotional exhaustion in the association between psychological detachment and depressive symptoms and the moderating role of self-compassion in the relationship between emotional exhaustion and depressive symptoms on the basis of the recovery-engagement-exhaustion model and emotion regulation theory. Through an online survey, relevant data were collected from 727 university teachers (mean age, 37.65 ± 7.77 years; 38.5% men). Indirect and moderation effect were analyzed through structural equation modeling (Mplus). Psychological detachment was found to be associated with depressive symptoms through emotional exhaustion. Self-compassion moderated the association between emotional exhaustion and depressive symptoms. The association between emotional exhaustion and depressive symptoms was weaker among university teachers with high levels of self-compassion than among those with low levels of self-compassion. This study improves our understanding of the association between psychological detachment and depressive symptoms by identifying the emotional pathway and protective function of self-compassion. Interventions for improving mental health in work context should be designed considering psychological detachment and self-compassion to deal with work-induced emotional strain.

Work Stress and Personal and Relational Well-Being Among Chinese College Teachers: The Indirect Roles of Sense of Control and Work-Related Rumination.

Purpose: The association between work stress and well-being has been well documented. However, the underlying mechanism for such association is not clear, especially in terms of how work stress relates to both personal and relational well-being. Based on the Conservation of Resources Theory and the Stress Process Model, the present study examined the potential indirect roles of the sense of control and the work-related rumination in the associations between work stress and both personal and relational well-being. Methods: Data were collected from 536 married Chinese university teachers (Mage = 39.40 + 7.64, 38.6% males) through an online survey. Analyses were conducted using structural equation modeling via Mplus. Results: Work stress was indirectly associated with life satisfaction through (a) sense of control, (b) work-related rumination, and (c) a sequential pathway from sense of control to work-related rumination. Work stress was indirectly associated with relationship satisfaction through sense of control. Conclusion: Findings suggest that sense of control would be an important linking mechanism underlying the association between work stress and college teachers' well-being. Personal well-being may be more vulnerable to work-related rumination than relational well-being. Insights for prevention and intervention efforts in enriching college teachers' well-being are discussed.

Association Between Pandemic Fatigue and Subjective Well-Being: The Indirect Role of Emotional Distress and Moderating Role of Self-Compassion.

Objectives: As a stressor in the context of COVID-19 pandemic fatigue is associated with well-being. However, how pandemic fatigue is associated with well-being and what protective factors buffer this negative effect are under investigated. Based on the stress process model and emotion regulation theory, the study examined the indirect effect of pandemic fatigue on subjective well-being through emotional distress and the buffering effect of self-compassion. Methods: Data were collected from 1,162 university students (M age = 21.61 ± 2.81, female 35.71%) through an online survey. Indirect effect analysis and conditional process analysis were conducted by the SPSS macro PROCESS. Results: Indirect effect of pandemic fatigue on subjective well-being through emotional distress was identified and self-compassion moderated the association between pandemic fatigue and emotional distress. The indirect effect of pandemic fatigue was weaker among participants with high levels of self-compassion than among those with low levels of self-compassion. Conclusion: Pandemic fatigue was negatively associated with subjective well-being through emotional distress at all levels of self-compassion. The findings deepen our understanding of the link between pandemic fatigue and well-being while considering the indirect role of emotional distress and protective function of self-compassion.

Work Stress, Work-Related Rumination, and Depressive Symptoms in University Teachers: Buffering Effect of Self-Compassion.

Purpose: The association between work stress and depressive symptoms has been well documented. More research is still needed to further investigate the underlying explanatory process mechanism and the potential protective function of personal resource in attenuating the negative effect of work stress on mental health. To address this gap and informed by the stress process model and emotion regulation theory,the present study examined the indirect role of work-related rumination and the buffering effect of self-compassion in university teachers, a population with increased vulnerabilities for both work stress and mental health issues. Methods: This study collected data from 727 university teachers (M age = 37.65 ± 7.77 years, 61.5% women) through an online survey. Indirect effect analysis and moderation effect analysis were implemented using structural equation modeling via Mplus. Results: Work stress was directly and indirectly associated with depressive symptoms through work-related rumination, and self-compassion moderated the associations between (a) work stress and depressive symptoms and (b) work-related rumination and depressive symptoms. The direct and indirect effects of work stress on depressive symptoms were weaker in university teachers with high levels of self-compassion than in those with low levels of self-compassion. Conclusion: Work stress was associated with depressive symptoms through a cognitive pathway. The findings deepen our understanding of the link between work stress and mental health outcomes by revealing the indirect role of cognitive processes, the protective function of emotion regulation strategies, and their interplay. Reducing work-related rumination and strengthening self-compassion may constitute effective interventions to alleviate the negative effects of work stress on mental health.

Oppositional Defiant Disorder Symptoms and Multi-level Family Factors in Chinese Migrant Children: A Network Perspective.

Based on the network theory of mental disorders, this study used network analysis to examine the network of ODD symptoms and multilevel family factors and identify the most crucial family factors influencing ODD symptoms in children. A total of 718 Chinese migrant children aged 7-14 years participated in this study. This study measured ODD symptoms, family system-level variables (3 factors), family dyadic-level variables (6 factors), and family individual-level variables (6 factors) with factors selected based on the multilevel family factors theory of ODD symptoms. The results indicated that (1) "annoy" was the center symptom of ODD, (2) "annoy" and "vindictive" was the main bridge connecting the multilevel family factors, and (3) family cohesion at the family system level, parent-child conflict at the family dyadic level, and parental depression at the family individual level were critical central and bridging influencing factors. The findings of this study highlight the critical role of "annoy" and "vindictive" symptoms in the activation of ODD symptom networks in children and provide a basis for future improvements in diagnostic criteria. These potential core and bridge factors might become key intervention targets for childhood ODD.

Unidirectional or Bidirectional? Relation between Parental Responsiveness and Emotion Regulation in Children with and without Oppositional Defiant Disorder.

Parenting is crucial for emotion regulation in children. Much less is known, however, concerning the association between parenting and emotion regulation in children with oppositional defiant disorder (ODD), who are known to have poor emotion regulation. The current study aimed to examine how parental responsiveness and child emotion regulation related either unidirectionally or bidirectionally to one another over time and to investigate whether the associations were different in ODD and non-ODD groups. Data were collected each year for three consecutive years from a sample of 256 parents of children with ODD and 265 parents of children without ODD in China. The results from the random intercepts cross-lagged panel model (RI-CLPM) suggested that the directionality of the link between parental responsiveness and child emotion regulation differs according to ODD status. The non-ODD group demonstrated a unidirectional link between early emotion regulation and subsequent parental responsiveness, consistent with the "child effect". However, in the ODD group, the link between parental responsiveness and emotion regulation was transactional, in line with social coercion theory. Multiple-group comparisons found that increased parental responsiveness was more strongly associated with improved child emotion regulation in the ODD group only. The research established a dynamic and longitudinal relationship between parental responsiveness and emotion regulation and suggested that intensive interventions should aim to improve parental responsiveness to children with ODD.

Role of self-esteem in the association between mindset of socioeconomic status and well-being: A cross-lagged panel analysis.

People who believe that their socioeconomic status (SES) can be changed-with growth mindset or incremental implicit theory of SES-tend to have better psychological well-being. Nevertheless, it remains unclear on why growth mindset of SES benefits well-being. The present research aims to answer this question by investigating the longitudinal associations between mindset of SES and well-being (i.e. depression and anxiety) and a potential mechanism (i.e. self-esteem). We recruited 600 adults in Guangzhou, China, as participants in this study. Participants completed a list of questionnaires containing measures of mindset of SES, self-esteem, depression, and anxiety at three time points over the course of 18 months. The cross-lagged panel model showed that individuals holding a growth mindset of SES reported significantly lower depression and anxiety 1 year later, but the effect was not sustained later. More importantly, self-esteem accounted for the associations of mindset of SES with both depression and anxiety, such that individuals with growth mindset of SES had higher self-esteem, and in turn, demonstrated lower depression and anxiety over 18 months. These findings deepen the understanding of the salutary effects of implicit theories of SES on psychological well-being. Implications for future research and mindset-related interventions are discussed.

Association between self-compassion and cyber aggression in the COVID-19 context: roles of attribution and public stigma.

Self-compassion is negatively associated with aggressive behaviors. However, the association between self-compassion and cyber aggression toward stigmatized people (e.g., people infected with COVID-19) has not been investigated in the COVID-19 context and the mechanism underlying this association remains underexplored. On the basis of emotion regulation theory and attribution theory, this study examined the indirect effects of self-compassion on cyber aggression toward people infected with COVID-19 through attribution and public stigma of COVID-19. Data were collected from 1162 Chinese college students (415 male, mean age = 21.61 years). Participants completed an online questionnaire including measurement of the key variables and basic demographic information. Results indicated that self-compassion was negatively associated with cyber aggression through the lower attribution of COVID-19 and lower public stigma of COVID-19. A sequential pathway from the attribution of COVID-19 to public stigma of COVID-19 was identified in the relationship between self-compassion and cyber aggression. Our findings are consistent with emotion regulation theory and attribution theory, which posit that emotion regulation strategies are associated with interpersonal mistreatment through cognitive pathways. These findings suggest that emotional self-regulation strategies can be used to reduce cyber aggression toward stigmatized people by reducing attribution and public stigma in the COVID-19 context. Self-compassion improvement could be target for the interventions aiming at alleviating public stigma and interpersonal mistreatment toward stigmatized people.

Caregivers' joint depressive symptoms and preschoolers' daily routines in Chinese three-generation families: Does household chaos matter?

The benefits of routines for children have been consistently demonstrated in previous literature. However, factors that may confer risks for child routines have seldom been examined, particularly in families where parents and grandparents co-care the children. This study aimed to investigate the associations of parents' and grandparents' depressive symptoms with preschoolers' daily routines in Chinese three-generation families and to determine whether household chaos mediated or moderated the associations. The participants were from 171 urban three-generation families where mothers, fathers, and grandmothers (97 paternal and 74 maternal) were primary caregivers. Mothers, fathers, and grandmothers reported their depressive symptoms at Wave 1; at Wave 2 (during the COVID-19 pandemic), caregivers reported household chaos and child routines. The results revealed that child routines were negatively predicted by parents' joint depressive symptoms rather than grandmothers' depressive symptoms. In the associations, household chaos acted as a mediator rather than a moderator. Specifically, household chaos marginally mediated the associations between parents' and grandmothers' depressive symptoms and child routines only in maternal three-generation families. These findings suggest that in three-generation families, caregivers with more depressive symptoms may elicit more chaotic family environments, which may in turn compromise their children's daily routines.

Potential markers of cancer stem-like cells in ESCC: a review of the current knowledge.

In patients with esophageal squamous cell carcinoma (ESCC), the incidence and mortality rate of ESCC in our country are also higher than those in the rest of the world. Despite advances in the treatment department method, patient survival rates have not obviously improved, which often leads to treatment obstruction and cancer repeat. ESCC has special cells called cancer stem-like cells (CSLCs) with self-renewal and differentiation ability, which reflect the development process and prognosis of cancer. In this review, we evaluated CSLCs, which are identified from the expression of cell surface markers in ESCC. By inciting EMTs to participate in tumor migration and invasion, stem cells promote tumor redifferentiation. Some factors can inhibit the migration and invasion of ESCC via the EMT-related pathway. We here summarize the research progress on the surface markers of CSLCs, EMT pathway, and the microenvironment in the process of tumor growth. Thus, these data may be more valuable for clinical applications.

Affective Profiles and Psychosocial Adjustment among Chinese Adolescents and Adults with Adverse Childhood Experiences: A Person-Centered Approach.

Purpose: Two studies were conducted to explore the patterns of positive affect (PA) and negative affect (NA) while considering collectivist cultural specificity (dialecticism) and to examine the associations of affective profiles with psychosocial adjustment. Methods: We used two Chinese samples, one comprising adults with adverse childhood experiences (N = 488) and one comprising ordinary adolescents (N = 635). The participants completed scales on PA, NA, and psychosocial adjustment, including mental health problems (depressive symptoms, anxiety), personal strengths (self-esteem, gratitude, resilience), and life satisfaction. Results: Three profiles were identified through latent profile analysis: well-adjusted (high PA, low NA), low affective (low PA, low NA), and moderate affective (moderate PA, moderate NA). Participants in the well-adjusted profile had the fewest mental health problems (depressive symptoms, anxiety) and scored highest on personal strengths (self-esteem, gratitude, resilience) and life satisfaction. Participants in the low affective profile had fewer mental health problems than those in the moderate affective profile. Conclusion: Individual differences and cultural variations should be considered when exploring affective profiles. Future interventions aimed at promoting affective well-being should accommodate dialecticism and individual differences in the target population. Supplementary Information: The online version contains supplementary material available at 10.1007/s10902-022-00566-7.

Identification and immune characteristics of molecular subtypes related to fatty acid metabolism in idiopathic pulmonary fibrosis.

Background: Although fatty acid metabolism has been confirmed to be involved in the pathological process of idiopathic pulmonary fibrosis (IPF), systematic analyses on the immune process mediated by fatty acid metabolism-related genes (FAMRGs) in IPF remain lacking. Methods: The gene expression data of 315 patients with IPF were obtained from Gene Expression Omnibus database and were divided into the training and verification sets. The core FAMRGs of the training set were identified through weighted gene co-expression network analysis. Then, the fatty acid metabolism-related subtypes in IPF were identified on the basis of k-means unsupervised clustering. The scores of fatty acid metabolism and the expression of the fibrosis biomarkers in different subtypes were compared, and functional enrichment analysis was carried out on the differentially expressed genes between subtypes. A random forest model was used to select important FAMRGs as diagnostic markers for distinguishing between subtypes, and a line chart model was constructed and verified by using other datasets and rat models with different degrees of pulmonary fibrosis. The difference in immune cell infiltration among subtypes was evaluated with CIBERSORT, and the correlation between core diagnostic markers and immune cells were analyzed. Results: Twenty-four core FAMRGs were differentially expressed between the training set and normal samples, and IPF was divided into two subtypes. Significant differences were observed between the two subtypes in biological processes, such as linoleic acid metabolism, cilium movement, and natural killer (NK) cell activation. The subtype with high fatty acid metabolism had more severe pulmonary fibrosis than the other subtype. A reliable construction line chart model based on six diagnostic markers was constructed, and ABCA3 and CYP24A1 were identified as core diagnostic markers. Significant differences in immune cell infiltration were found between the two subtypes, and ABCA3 and CYP24A1 were closely related to NK cells. Conclusion: Fatty acid metabolism and the immune process that it mediates play an important role in the occurrence and development of IPF. The analysis of the role of FAMRGs in IPF may provide a new potential therapeutic target for IPF.

Social Class-Based Discrimination and Psychological Symptoms Among Socioeconomically Disadvantaged College Students: The Moderated Mediation Role of Stress Mindset and Rumination.

Discrimination as a crucial stressor damages the mental health of socioeconomically disadvantaged individuals through increased ruminative thinking. A "stress-is-enhancing" mindset may protect the mental health of socioeconomically disadvantaged individuals under the pressures of perceived discrimination and rumination. This study examined the mediating role of rumination and the moderating role of stress mindset in the relationship between perceived discrimination and psychological symptoms among socioeconomically disadvantaged college students. A total of 919 socioeconomically disadvantaged undergraduate students (48.4% female, ages 17-25) were recruited. The results indicated that perceived discrimination was positively associated with psychological symptoms among socioeconomically disadvantaged undergraduate students through rumination (B = 0.11, boot SE = 0.01, boot 95% CIs = [0.08, 0.13]). Importantly, stress mindset moderated the indirect association between perceived discrimination and psychological distress through rumination (B = -0.18, boot SE = 0.08, boot 95% CIs = [-0.32, -0.03]). Specifically, compared with individuals with low levels of the stress-is-enhancing mindset, the indirect effect of perceived discrimination on psychological distress through rumination was weaker among individuals with high levels of the stress-is-enhancing mindset. The findings provide support for future intervention practice to promote a stress-is-enhancing mindset to protect the mental health of socioeconomically disadvantaged college students under the pressures of perceived discrimination and rumination.

Childhood emotional maltreatment and subsequent affective symptoms among chinese male drug users: The roles of impulsivity and psychological resilience.

OBJECTIVE: Childhood emotional maltreatment (CEM) has been widely linked to later affective symptoms. What still remains inadequately understood are the potential nuanced differences in the consequences of childhood emotional abuse (CEM-A) versus childhood emotional neglect (CEM-N) and the implicated mechanisms. Research with non-Western, clinical samples also remains scarce. Thus, we examined the associations of CEM-A and CEM-N with later affective symptoms among Chinese male drug users and tested impulsivity and psychological resilience as potential mediators and moderators. METHOD: Structural equation modeling analyses were conducted with survey data obtained from 239 Chinese male adult drug users who were in a rehabilitation center. RESULTS: The mediating rather than the moderating hypotheses were supported. CEM-A was found to be positively associated with subsequent depressive and anxious symptoms through a positive association with impulsivity. In contrast, CEM-N was positively associated only with subsequent depressive symptoms via a negative association with psychological resilience. In addition, CEM-A was also found to be directly associated with later depressive and anxious symptoms. CONCLUSIONS: CEM may pose a threat to later affective well-being partly through contributing to intrapersonal vulnerabilities as well as compromising intrapersonal strengths. Differentiating CEM-A and CEM-N appears to be critical for revealing the understudied specificity and nuance that may be inherently within such effects. Drug use treatment services should sensitively attend to the affective sequelae of CEM. Interventions targeted at the modification of impulsivity and the facilitation of psychological resilience may be effective in diminishing the affective consequences of CEM among drug users. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Long-Term Trajectories of Depressive Symptoms Among Children Affected by Parental HIV: A 12-Year Follow-Up Study.

The present study explored the trajectories of depressive symptoms over 12 years spanning from childhood to emerging adulthood and the between-trajectory differences in psychosocial adjustment among Chinese children (N = 492, 52.8% boys, aged 6 to 18 years at baseline) affected by parental HIV. Rebounding (12.6%), resilient (64.8%), and improving  (22.6%) trajectories were identified. Individuals in the rebounding trajectory reported the highest levels of psychological distress and the lowest levels of subjective well-being, positive self-regard, and personal strengths in adulthood. Individuals in the resilient trajectory reported lower levels of psychological distress and negative affect than those in the improving trajectory. The findings support the development of programs by policymakers and practitioners to improve the psychosocial adjustment of children who have been affected by parental HIV while considering individual differences in the trajectories of depressive symptoms.

Disease-Related Risk Factors for Caregiver Burden among Family Caregivers of Persons with Schizophrenia: A Systematic Review and Meta-Analysis.

This study aimed to conduct a quantitative synthesis of the clinical correlates of caregiver burden in schizophrenia studies published in the last two decades. Derived from eight electronic databases, this meta-analytic review revisits 34 English articles published from 2000 to 2020 relevant to family caregiver burden in the schizophrenia field. The Newcastle-Ottawa Scale (NOS) was used to assess study quality. The pooled effect sizes of the selected studies ranged from -0.390 to 0.751. The results indicated a significant association between a heavier burden and disease-related risk factors, including more severe symptoms, greater general psychopathology, greater severity of functional impairment, and longer duration of illness. The results show moderating effects of study characteristics (i.e., study quality, participants, and location) on the correlations between these disease-related risk factors and caregiver burden. This review highlights the roles of study characteristics in affecting the inconsistent results for the effects of disease-related risk factors on caregiver burden in families of patients with schizophrenia. Psychosocial interventions are essential for family caregivers of persons with schizophrenia. Future studies incorporating random samples from both high-income and low-to-middle-income countries will be crucial to understand the effects of cultural contexts on caregiver burden in families of persons with schizophrenia.